Basic Information
| Provider Information | |||||||||
| NPI: | 1417973249 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CALENDINE | ||||||||
| FirstName: | CORY | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 206 BEDFORD WAY | ||||||||
| Address2: | |||||||||
| City: | FRANKLIN | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370645526 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6157903290 | ||||||||
| FaxNumber: | 6157948845 | ||||||||
| Practice Location | |||||||||
| Address1: | 4323 CAROTHERS PKWY STE 201 | ||||||||
| Address2: | |||||||||
| City: | FRANKLIN | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370675973 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6157912630 | ||||||||
| FaxNumber: | 6157912639 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/14/2006 | ||||||||
| LastUpdateDate: | 11/30/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207XS0114X | 0101239496 | VA | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Adult Reconstructive Orthopaedic Surgery | 207XS0114X | MD38613 | TN | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Adult Reconstructive Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | MD0000038613 | 01 | TN | LICENSE TO PRACTICE | OTHER | 0101239496 | 01 | VA | VA LICENSE TO PRACTICE | OTHER |